Search results for: benefits of social media use
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13458

Search results for: benefits of social media use

3978 From Scalpel to Leadership: The Landscape for Female Neurosurgeons in the UK

Authors: Anda-veronica Gherman, Dimitrios Varthalitis

Abstract:

Neurosurgery, like many surgical specialties, undoubtedly exhibits a significant gender gap, particularly in leadership positions. While increasing women representation in neurosurgery is important, it is crucial to increase their presence in leadership positions. Across the globe and Europe there are concerning trends of only 4% of all neurosurgical departments being chaired by women. This study aims to explore the situation regarding gender disparities in leadership in the United Kingdom and to identify possible contributing factors as well as discussing future strategies to bridge this gap. Methods: A literature review was conducted utilising PubMed as main database with search keywords including ‘female neurosurgeon’, ‘women neurosurgeon’, ‘gender disparity’, ‘leadership’ and ‘UK’. Additionally, a manual search of all neurosurgical departments in the UK was performed to identify the current female department leads and training director leads. Results: The literature search identified a paucity of literature addressing specifically leadership in female neurosurgeons within the UK, with very few published papers specifically on this topic. Despite more than half of medical students in the UK being female, only a small proportion pursue a surgical career, with neurosurgery being one of the least represented specialties. Only 27% of trainee neurosurgeons are female, and numbers are even lower at a consultant level, where women represent just 8%.Findings from published studies indicated that only 6.6% of leadership positions in neurosurgery are occupied by women in the UK. Furthermore, our manual searches across UK neurosurgical departments revealed that around 5% of department lead positions are currently held by women. While this figure is slightly higher than the European average of 4%, it remains lower compared to figures of 10% in other North-West European countries. The situation is slightly more positive looking at the training directors, with 15% being female. Discussion: The findings of this study highlight a significant gender disparity in leadership positions within neurosurgery in the UK, which may have important implications, perpetuating the lack of diversity on the decision-making process, limiting the career advancement opportunities of women and depriving the neurosurgical field from the voices, opinions and talents of women. With women representing half of the population, there is an undeniable need for more female leaders at the policy-making level. There are many barriers that can contribute to these numbers, including bias, stereotypes, lack of mentorship and work-like balance. A few solutions to overcome these barriers can be training programs addressing bias and impostor syndrome, leadership workshops tailored for female needs, better workplace policies, increased in formal mentorship and increasing the visibility of women in neurosurgery leadership positions through media, speaking opportunities, conferences, awards etc. And lastly, more research efforts should focus on the leadership and mentorship of women in neurosurgery, with an increased number of published papers discussing these issues.

Keywords: female neurosurgeons, female leadership, female mentorship, gender disparities

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3977 Convergence of Strategic Tasks of Business Tourism and Hotel Industry Development: The Case of Georgia

Authors: Nana Katsitadze, Tamar Atanelishvili, Mariam Kutateladze, Alexandre Tushishvili

Abstract:

In the modern world, tourism has emerged as one of the most powerful economic sectors, and due to its high economic performance, it is attractive to the countries with various levels of economic development. The purpose of the present paper, dedicated to discussing the current problems of tourism development, is to find ways which will contribute to bringing more benefits to the country from the sector. Georgia has been successfully developing leisure tourism for the last ten years, and at the next stage of development business, tourism gains particular importance for Georgia as a means of mitigating the negative socio-economic effects caused by the seasonality of tourism and as a high-cost tourism market. Therefore, the object of the paper is to study the factors that contribute to the development of business tourism. The paper uses the research methods such as system analysis, synthesis, analogy, as well as historical, comparative, economic, and statistical methods of analysis. The information base for the research is made up of the statistics on the functioning of the tourism market of Georgia and foreign countries as well as official data provided by international organizations in the field of tourism. Based on the experience of business tourism around the world and identifying the successful start of business tourism development in Georgia and its causing factors, a business tourism development model for Georgia has been developed. The model might be useful as a methodological material for developing a business tourism development concept for the countries with limited financial resources but rich in tourism resources like Georgia. On the initial stage of development (in absence of conventional centers), the suggested concept of business tourism development involves organizing small and medium-sized meetings both in large cities and in regions by using high-class hotel infrastructure and event management services. Relocation of small meetings to the regions encourages inclusive development of the sector based on increasing the awareness of these regions as tourist sites as well as the increase in employment and sales of other tourism or consumer products. Business tourism increases the number of hotel visitors in the non-seasonal period and improves hotel performance indicators, which enhances the attractiveness of investing in the hotel business. According to the present concept of business tourism development, at the initial stage, development of business tourism is based on the existing markets, including internal market, neighboring markets and the markets of geographically relatively near countries and at the next stage, the concept involves generating tourists from other relatively distant target markets. As a result, by gaining experience in business tourism, enhancing professionalism, increasing awareness and stimulating infrastructure development, the country will prepare the basis to move to a higher stage of tourism development. In addition, the experience showed that for attracting large customers, peculiarities of the field require activation of state policy and active use of marketing mechanisms and tools of the state.

Keywords: hotel industry development, MICE model, MICE strategy, MICE tourism in Georgia

Procedia PDF Downloads 141
3976 Developing Thai-UK Double Degree Programmes: An Exploratory Study Identifying Challenges, Competing Interests and Risks

Authors: Joy Tweed, Jon Pike

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In Thailand, a 4.0 policy has been initiated that is designed to prepare and train an appropriate workforce to support the move to a value-based economy. One aspect of support for this policy is a project to encourage the creation of double degree programmes, specifically between Thai and UK universities. This research into the project, conducted with its key players, explores the factors that can either enable or hinder the development of such programmes. It is an area that has received little research attention to date. Key findings focus on differences in quality assurance requirements, attitudes to benefits, risks, and committed levels of institutional support, thus providing valuable input into future policy making. The Transnational Education (TNE) Development Project was initiated in 2015 by the British Council, in conjunction with the Office for Higher Education Commission (OHEC), Thailand. The purpose of the project was to facilitate opportunities for Thai Universities to partner with UK Universities so as to develop double degree programme models. In this arrangement, the student gains both a UK and a Thai qualification, spending time studying in both countries. Twenty-two partnerships were initiated via the project. Utilizing a qualitative approach, data sources included participation in TNE project workshops, peer reviews, and over 20 semi-structured interviews conducted with key informants within the participating UK and Thai universities. Interviews were recorded, transcribed, and analysed for key themes. The research has revealed that the strength of the relationship between the two partner institutions is critical. Successful partnerships are often built on previous personal contact, have senior-level involvement and are strengthened by partnership on different levels, such as research, student exchange, and other forms of mobility. The support of the British Council was regarded as a key enabler in developing these types of projects for those universities that had not been involved in TNE previously. The involvement of industry is apparent in programmes that have high scientific content but not well developed in other subject areas. Factors that hinder the development of partnership programmes include the approval processes and quality requirements of each institution. Significant differences in fee levels between Thai and UK universities provide a challenge and attempts to bridge them require goodwill on the part of the latter that may be difficult to realise. This research indicates the key factors to which attention needs to be given when developing a TNE programme. Early attention to these factors can reduce the likelihood that the partnership will fail to develop. Representatives in both partner universities need to understand their respective processes of development and approval. The research has important practical implications for policy-makers and planners involved with TNE, not only in relation to the specific TNE project but also more widely in relation to the development of TNE programmes in other countries and other subject areas. Future research will focus on assessing the success of the double degree programmes generated by the TNE Development Project from the perspective of universities, policy makers, and industry partners.

Keywords: double-degree, internationalization, partnerships, Thai-UK

Procedia PDF Downloads 93
3975 Regulating Green Roofs: A Review of the Relation between Current International Regulations and Economic, Environmental and Social Effects

Authors: Marianna Nigra, Maicol Negrello

Abstract:

Efficiency, productivity, and sustainability are important factors for structure and the application of processes in green building. Various previous studies have addressed efficiency, productivity, and sustainability separately. This research study aims to investigate the implications of these three factors taking together. Frequency analysis and the ranking techniques are carried out to explore the connection between these factors. The interconnection matrix has been developed and functional grouping is made based upon data from expert opinion and field professionals. The existence of a relationship, the type of relationship and the scaled impact have been drawn. Additionally, a system diagram has been developed to show the variable correlation. The results of expert opinion show that efficiency, productivity, and sustainability have a stronger impact on green buildings.

Keywords: green roof regulation, architecture, climate adaptation, resilience, innovation management

Procedia PDF Downloads 94
3974 Transnational Rurality: Bridging Two Towns with Renewable Energy

Authors: Yaprak Aydin

Abstract:

The rural is no longer a space of only agricultural activities that gave into the global market demands; or an idyll to return after retirement; or only a reservoir of cultural values, but rather a vision to redefine the future in terms of production and consumption relations. Gulpınar in Turkey and Ashtarak in Armenia are two towns where a new ground of dialogue between two communities has been initiated: ‘energy democracy’, which is a significant driving force in a sense of gathering people of two historically conflicted communities around common future concerns; and in a sense of transforming the accepted knowledge on the rurality and all the social structures it represents. This paper seeks to provoke a discussion of to what extent such a rurality is attainable by contextualizing – through visits and meetings in person – two towns and two communities within a renewable energy project called 'Under the Same Sun' carried out by two local civil society organizations together at two public spaces.

Keywords: civil society, energy democracy, prosumer communities, renewable energy, transnational rurality

Procedia PDF Downloads 131
3973 A Social-Environmental Way for Production of Building Materials with Solid Residues

Authors: Flavio Araujo, Julio Lima, Paulo Scalize, Antonio Albuquerque

Abstract:

Water treatment residues (WTR) are produced during water treatment and have recently been seen as a reusable material. The aim of this research was to perform characterizations of the residue generated in the Meia-Ponte Water Treatment Plant, in Goiania, Brazil, seeking to obtain normative parameters and consider sustainable alternatives for reincorporation of the residues in the productive chain for manufacturing various materials construction. In order to reduce the environmental liabilities generated by sanitation companies and discontinue unsustainable forms of disposal. The analyzes performed: Granulometry, Scanning Electron Microscopy, and X-Ray Diffraction demonstrated the potential application of residues to replace the soil and sand, because it has characteristics compatible with small aggregate and can be used as feed stock for the manufacture of materials as ceramic and soil-cement bricks, mortars, interlocking floors and concrete artifacts.

Keywords: residue, sustainable, water treatment plants, WTR

Procedia PDF Downloads 528
3972 Developing a Tissue-Engineered Aortic Heart Valve Based on an Electrospun Scaffold

Authors: Sara R. Knigge, Sugat R. Tuladhar, Alexander Becker, Tobias Schilling, Birgit Glasmacher

Abstract:

Commercially available mechanical or biological heart valve prostheses both tend to fail long-term due to thrombosis, calcific degeneration, infection, or immunogenic rejection. Moreover, these prostheses are non-viable and do not grow with the patients, which is a problem for young patients. As a result, patients often need to undergo redo-operations. Tissue-engineered (TE) heart valves based on degradable electrospun fiber scaffolds represent a promising approach to overcome these limitations. Such scaffolds need sufficient mechanical properties to withstand the hydrodynamic stress of intracardiac hemodynamics. Additionally, the scaffolds should be colonized by autologous or homologous cells to facilitate the in vivo remodeling of the scaffolds to a viable structure. This study investigates how process parameters of electrospinning and degradation affect the mechanical properties of electrospun scaffolds made of FDA-approved, biodegradable polymer polycaprolactone (PCL). Fiber mats were produced from a PCL/tetrafluoroethylene solution by electrospinning. The e-spinning process was varied in terms of scaffold thickness, fiber diameter, fiber orientation, and fiber interconnectivity. The morphology of the fiber mats was characterized with a scanning electron microscope (SEM). The mats were degraded in different solutions (cell culture media, SBF, PBS and 10 M NaOH-Solution). At different time points of degradation (2, 4 and 6 weeks), tensile and cyclic loading tests were performed. Fresh porcine pericardium and heart valves served as a control for the mechanical assessment. The progression of polymer degradation was quantified by SEM and differential scanning calorimetry (DSC). Primary Human aortic endothelial cells (HAECs) and Human induced pluripotent stem cell-derived endothelial cells (iPSC-ECs) were seeded on the fiber mats to investigate the cell colonization potential. The results showed that both the electrospinning parameters and the degradation significantly influenced the mechanical properties. Especially the fiber orientation has a considerable impact and leads to a pronounced anisotropic behavior of the scaffold. Preliminary results showed that the polymer became strongly more brittle over time. However, the embrittlement can initially only be detected in the mechanical test. In the SEM and DSC investigations, neither morphological nor thermodynamic changes are significantly detectable. Live/Dead staining and SEM imaging of the cell-seeded scaffolds showed that HAECs and iPSC-ECs were able to grow on the surface of the polymer. In summary, this study's results indicate a promising approach to the development of a TE aortic heart valve based on an electrospun scaffold.

Keywords: electrospun scaffolds, long-term polymer degradation, mechanical behavior of electrospun PCL, tissue engineered aortic heart valve

Procedia PDF Downloads 125
3971 The Production of Biofertilizer from Naturally Occurring Microorganisms by Using Nuclear Technologies

Authors: K. S. Al-Mugren, A. Yahya, S. Alodah, R. Alharbi, S. H. Almsaid , A. Alqahtani, H. Jaber, A. Basaqer, N. Alajra, N. Almoghati, A. Alsalman, Khalid Alharbi

Abstract:

Context: The production of biofertilizers from naturally occurring microorganisms is an area of research that aims to enhance agricultural practices by utilizing local resources. This research project focuses on isolating and screening indigenous microorganisms with PK-fixing and phosphate solubilizing characteristics from local sources. Research Aim: The aim of this project is to develop a biofertilizer product using indigenous microorganisms and composted agro waste as a carrier. The objective is to enhance crop productivity and soil fertility through the application of biofertilizers. Methodology: The research methodology includes several key steps. Firstly, indigenous microorganisms will be isolated from local resources using the ten-fold serial dilutions technique. Screening assays will be conducted to identify microorganisms with phosphate solubilizing and PK-fixing activities. Agro-waste materials will be collected from local agricultural sources, and composting experiments will be conducted to convert them into organic matter-rich compost. Physicochemical analysis will be performed to assess the composition of the composted agro-waste. Gamma and X-ray irradiation will be used to sterilize the carrier material. The sterilized carrier will be tested for sterility using the ten-fold serial dilutions technique. Finally, selected indigenous microorganisms will be developed into biofertilizer products. Findings: The research aims to find suitable indigenous microorganisms with phosphate solubilizing and PK-fixing characteristics for biofertilizer production. Additionally, the research aims to assess the suitability of composted agro waste as a carrier for biofertilizers. The impact of gamma irradiation sterilization on pathogen elimination will also be investigated. Theoretical Importance: This research contributes to the understanding of utilizing indigenous microorganisms and composted agro waste for biofertilizer production. It expands knowledge on the potential benefits of biofertilizers in enhancing crop productivity and soil fertility. Data Collection and Analysis Procedures: The data collection process involves isolating indigenous microorganisms, conducting screening assays, collecting and composting agro waste, analyzing the physicochemical composition of composted agro waste, and testing carrier sterilization. The analysis procedures include assessing the abilities of indigenous microorganisms, evaluating the composition of composted agro waste, and determining the sterility of the carrier material. Conclusion: The research project aims to develop biofertilizer products using indigenous microorganisms and composted agro waste as a carrier. Through the isolation and screening of indigenous microorganisms, the project aims to enhance crop productivity and soil fertility by utilizing local resources. The research findings will contribute to the understanding of the suitability of composted agro waste as a carrier and the efficacy of gamma irradiation sterilization. The research outcomes will have theoretical importance in the field of biofertilizer production and agricultural practices.

Keywords: biofertilizer, microorganisms, agro waste, nuclear technologies

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3970 The Psychological and Social Impacts of Climate Change: A Review of the Current State in Canada

Authors: Megan E. Davies

Abstract:

The effects of climate change impact the environment and our physical health but also demonstrate a growing risk factor for Canadians’ individual and collective mental health. Past research and expert predictions are discussed while exploring the connection between mental health concerns and climate change consequences, resulting in a call to action for psychological sciences to be integrated into solution planning. With the direct and indirect effects of climate change steadily increasing, political and legal aspects of sustainability, as well as the repercussions for mental health being seen in Canada regarding climate change, are investigated. An interdisciplinary perspective for reviewing the challenges of climate change is applied in order to propose a realistic plan for how policymakers and mental health professionals can work together moving forward in applying interventions that mediate against the effects of climate change on Canadians’ mental health.

Keywords: climate change, mental health, policy change, solution planning, sustainability

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3969 The Process of Critical Care Nursing Resilience in Workplace Adversity

Authors: Jennifer Jackson

Abstract:

Critical care nurses are at risk for burnout when confronted with sustained workplace adversity, which stems from a variety of social, structural, and environmental factors. Researchers have suggested that nurses can become resilient and overcome workplace adversity to achieve positive outcomes. The purpose of this study is to learn more about critical care nurses’ experiences with workplace adversity, and their process of becoming resilient. The research question will be: what is the process of critical care nursing resilience in workplace adversity? In-depth interviews with critical care nurses will provide the data to inductively generate the grounded theory. The resultant grounded theory will provide a framework to inform nurses and managers in developing interventions to support critical care nurses in their workplace. By enhancing nursing resilience, burnout may be avoided, and nurse satisfaction and overall quality of care may be improved.

Keywords: nursing, resilience, burnout, critical care

Procedia PDF Downloads 473
3968 Tips for Effective Intercultural Collaboration on the Evaluation of an International Program

Authors: Athanase Gahungu, Karen Freeman

Abstract:

Different groups of stakeholders expect the evaluation of an international, grant-funded program to inform them of the worth of the program - the funder, the agency operating the program and its community, and the citizens of the country where the program is implemented. This paper summarizes the challenges that intercultural teams of researchers faced as they crisscrossed a host country while evaluating a teaching and learning materials program, and offers useful tips for effective collaboration. Firstly, was recommended that the teams be representative of the cultures involved, and have the required research and program evaluation skills. Secondly, cultures involved must consistently establish and maintain a shared performance system. Thirdly, successful team members must be self-aware, inter-culturally knowledgeable, not just in communication, but in conceptualizing the political and social context of international grant-funded projects.

Keywords: program evaluation, international collaboration, intercultural, shared performance

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3967 Contributions of Non-Formal Educational Spaces for the Scientific Literacy of Deaf Students

Authors: Rafael Dias Silva

Abstract:

The school is a social institution that should promote learning situations that remain throughout life. Based on this, the teaching activities promoted in museum spaces can represent an educational strategy that contributes to the learning process in a more meaningful way. This article systematizes a series of elements that guide the use of these spaces for the scientific literacy of deaf students and as experiences of this nature are favorable for the school development through the concept of the circularity. The methodology for the didactic use of these spaces of non-formal education is one of the reflections developed in this study and how such environments can contribute to the learning in the classroom. To develop in the student the idea of ​​association making him create connections with the curricular proposal and notice how the proposed activity is articulated. It is in our interest that the experience lived in the museum be shared collaborating for the construction of a scientific literacy and cultural identity through the research.

Keywords: accessibility in museums, Brazilian sign language, deaf students, teacher training

Procedia PDF Downloads 222
3966 Identification of ω-3 Fatty Acids Using GC-MS Analysis in Extruded Spelt Product

Authors: Jelena Filipovic, Marija Bodroza-Solarov, Milenko Kosutic, Nebojsa Novkovic, Vladimir Filipovic, Vesna Vucurovic

Abstract:

Spelt wheat is suitable raw material for extruded products such as pasta, special types of bread and other products of altered nutritional characteristics compared to conventional wheat products. During the process of extrusion, spelt is exposed to high temperature and high pressure, during which raw material is also mechanically treated by shear forces. Spelt wheat is growing without the use of pesticides in harsh ecological conditions and in marginal areas of cultivation. So it can be used for organic and health safe food. Pasta is the most popular foodstuff; its consumption has been observed to rise. Pasta quality depends mainly on the properties of flour raw materials, especially protein content and its quality but starch properties are of a lesser importance. Pasta is characterized by significant amounts of complex carbohydrates, low sodium, total fat fiber, minerals, and essential fatty acids and its nutritional value can be improved with additional functional component. Over the past few decades, wheat pasta has been successfully formulated using different ingredients in pasta to cater health-conscious consumers who prefer having a product rich in protein, healthy lipids and other health benefits. Flaxseed flour is used in the production of bakery and pasta products that have properties of functional foods. However, it should be taken into account that food products retain the technological and sensory quality despite the added flax seed. Flaxseed contains important substances in its composition such as vitamins and minerals elements, and it is also an excellent source of fiber and one of the best sources of ω-3 fatty acids and lignin. In this paper, the quality and identification of spelt extruded product with the addition of flax seed, which is positively contributing to the nutritive and technology changes of the product, is investigated. ω-3 fatty acids are polyunsaturated essential fatty acids, and they must be taken with food to satisfy the recommended daily intake. Flaxseed flour is added in the quantity of 10/100 g of sample and 20/100 g of sample on farina. It is shown that the presence of ω-3 fatty acids in pasta can be clearly distinguished from other fatty acids by gas chromatography with mass spectrometry. Addition of flax seed flour influence chemical content of pasta. The addition of flax seed flour in spelt pasta in the quantities of 20g/100 g significantly increases the share of ω-3 fatty acids, which results in improved ratio of ω-6/ω-3 1:2.4 and completely satisfies minimum daily needs of ω-3 essential fatty acids (3.8 g/100 g) recommended by FDA. Flex flour influenced the pasta quality by increasing of hardness (2377.8 ± 13.3; 2874.5 ± 7.4; 3076.3 ± 5.9) and work of shear (102.6 ± 11.4; 150.8 ± 11.3; 165.0 ± 18.9) and increasing of adhesiveness (11.8 ± 20.6; 9.,98 ± 0.12; 7.1 ± 12.5) of the final product. Presented data point at good indicators of technological quality of spelt pasta with flax seed and that GC-MS analysis can be used in the quality control for flax seed identification. Acknowledgment: The research was financed by the Ministry of Education and Science of the Republic of Serbia (Project No. III 46005).

Keywords: GC-MS analysis, ω-3 fatty acids, flex seed, spelt wheat, daily needs

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3965 The Economic Limitations of Defining Data Ownership Rights

Authors: Kacper Tomasz Kröber-Mulawa

Abstract:

This paper will address the topic of data ownership from an economic perspective, and examples of economic limitations of data property rights will be provided, which have been identified using methods and approaches of economic analysis of law. To properly build a background for the economic focus, in the beginning a short perspective of data and data ownership in the EU’s legal system will be provided. It will include a short introduction to its political and social importance and highlight relevant viewpoints. This will stress the importance of a Single Market for data but also far-reaching regulations of data governance and privacy (including the distinction of personal and non-personal data, data held by public bodies and private businesses). The main discussion of this paper will build upon the briefly referred to legal basis as well as methods and approaches of economic analysis of law.

Keywords: antitrust, data, data ownership, digital economy, property rights

Procedia PDF Downloads 63
3964 Health Post A Sustainable Prototype for the Third World

Authors: Chizzoniti Domenico, Beggiora Klizia, Cattani Letizia, Moscatelli Monica

Abstract:

This paper concerns the study of sustainable construction materials applied on the "Health Post", a prototype for the primary health care situated in alienated areas of the world. It's suitable for social and climatic Sub-Saharan context; however, it could be moved in other countries of the world with similar urgent needs. The idea is to create a Health Post with local construction materials that have a low environmental impact and promote the local workforce allowing reuse of traditional building techniques lowering production costs and transport. The aim of Primary Health Care Centre is to be a flexible and expandable structure identifying a modular form that can be repeated several times to expand its existing functions. In this way it could be not only a health care centre but also a socio-cultural facility.

Keywords: low costs building, sustainable construction materials, green construction system, prototype, health care, emergency

Procedia PDF Downloads 465
3963 Perception Differences in Children Learning to Golf with Traditional versus Modified (Scaled) Equipment

Authors: Lindsey D. Sams, Dean R. Gorman, Cathy D. Lirgg, Steve W. Dittmore, Jack C. Kern

Abstract:

Golf is a lifetime sport that provides numerous physical and psychological benefits. The game has struggled with attrition and retention within minority groups and this has exposed the lack of a modified introduction to the game that is uniformly accessible and developmentally appropriate. Factors that have been related to sport participatory behaviors include perceived competence, enjoyment and intention. The purpose of this study was to examine self-reported perception differences in competence and enjoyment between learners using modified and traditional equipment as well as the potential effects these factors could have on intent for future participation. For this study, SNAG Golf was chosen to serve as the scaled equipment used by the modified equipment group. The participants in this study were 99 children (24 traditional equipment users/ 75 modified equipment users) located across the U.S. with ages ranging from 7 to 12 years (2nd-5th grade). Utilizing a convenience sampling method, data was obtained on a voluntary basis through surveys measuring children’s golf participation and self-perceptions concerning perceived competence, enjoyment and intention to continue participation. The scales used for perceived competence and enjoyment included Susan Harter’s Self-Perception Profile for Children (SPPC) along with the Physical Activity Enjoyment Scale (PACES). Analysis revealed no significant differences for enjoyment, perceived competence or intention between children learning with traditional golf equipment and modified golf equipment. This was true even though traditional equipment users reported significantly higher experience levels than that of modified users. Intention was regressed on the enjoyment and perceived competence variables. Congruent with current literature, enjoyment was a strong predictor of intention to continue participation, for both groups. Modified equipment users demonstrated significantly lower experience levels but reported similar levels of competence, enjoyment and intent to continue participation as reported by the more experienced, and potentially more skilled, traditional users. The ability to immediately generate these positive affects suggests the potential adoption of a more effective way to learn golf and a method that is conducive to participatory behaviors related to attrition and retention. These implications in turn, highlight an equipment candidate ideal for inception into physical education programs where new learners are introduced to various sports in safe and developmentally appropriate environments. A major goal of this study was to provide foundational research that instigates the further examination of golf’s introductory teaching methodologies, as there is a lack of its presence in current literature. Future research recommendations range from improvements in the current research design to expansive approaches related to the topic, such as progressive skill development, knowledge of the game’s tactical and strategic concepts, playing ability and teaching effectiveness when utilizing modified versus traditional equipment.

Keywords: adaptive sports, enjoyment, golf participation, modified equipment, perceived competence, SNAG golf

Procedia PDF Downloads 326
3962 Perceptions on Development of the Deaf in Higher Education Level: The Case of Special Education Students in Tiaong, Quezon, Philippines

Authors: Ashley Venerable, Rosario Tatlonghari

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This study identified how college deaf students of Bartimaeus Center for Alternative Learning in Tiaong, Quezon, Philippines view development using visual communication techniques and generating themes from responses. Complete enumeration was employed. Guided by Constructivist Theory of Perception, past experiences and stored information influenced perception. These themes of development emerged: social development; pleasant environment; interpersonal relationships; availability of resources; employment; infrastructure development; values; and peace and security. Using the National Economic and Development Authority development indicators, findings showed the deaf students’ views on development were similar from the mainstream views. Responses also became more meaningful through visual communication techniques.

Keywords: deaf, development, perception, development indicators, visual communication

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3961 Understanding Cyber Terrorism from Motivational Perspectives: A Qualitative Data Analysis

Authors: Yunos Zahri, Ariffin Aswami

Abstract:

Cyber terrorism represents the convergence of two worlds: virtual and physical. The virtual world is a place in which computer programs function and data move, whereas the physical world is where people live and function. The merging of these two domains is the interface being targeted in the incidence of cyber terrorism. To better understand why cyber terrorism acts are committed, this study presents the context of cyber terrorism from motivational perspectives. Motivational forces behind cyber terrorism can be social, political, ideological and economic. In this research, data are analyzed using a qualitative method. A semi-structured interview with purposive sampling was used for data collection. With the growing interconnectedness between critical infrastructures and Information & Communication Technology (ICT), selecting targets that facilitate maximum disruption can significantly influence terrorists. This work provides a baseline for defining the concept of cyber terrorism from motivational perspectives.

Keywords: cyber terrorism, terrorism, motivation, qualitative analysis

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3960 A Geographical Information System Supported Method for Determining Urban Transformation Areas in the Scope of Disaster Risks in Kocaeli

Authors: Tayfun Salihoğlu

Abstract:

Following the Law No: 6306 on Transformation of Disaster Risk Areas, urban transformation in Turkey found its legal basis. In the best practices all over the World, the urban transformation was shaped as part of comprehensive social programs through the discourses of renewing the economic, social and physical degraded parts of the city, producing spaces resistant to earthquakes and other possible disasters and creating a livable environment. In Turkish practice, a contradictory process is observed. In this study, it is aimed to develop a method for better understanding of the urban space in terms of disaster risks in order to constitute a basis for decisions in Kocaeli Urban Transformation Master Plan, which is being prepared by Kocaeli Metropolitan Municipality. The spatial unit used in the study is the 50x50 meter grids. In order to reflect the multidimensionality of urban transformation, three basic components that have spatial data in Kocaeli were identified. These components were named as 'Problems in Built-up Areas', 'Disaster Risks arising from Geological Conditions of the Ground and Problems of Buildings', and 'Inadequacy of Urban Services'. Each component was weighted and scored for each grid. In order to delimitate urban transformation zones Optimized Outlier Analysis (Local Moran I) in the ArcGIS 10.6.1 was conducted to test the type of distribution (clustered or scattered) and its significance on the grids by assuming the weighted total score of the grid as Input Features. As a result of this analysis, it was found that the weighted total scores were not significantly clustering at all grids in urban space. The grids which the input feature is clustered significantly were exported as the new database to use in further mappings. Total Score Map reflects the significant clusters in terms of weighted total scores of 'Problems in Built-up Areas', 'Disaster Risks arising from Geological Conditions of the Ground and Problems of Buildings' and 'Inadequacy of Urban Services'. Resulting grids with the highest scores are the most likely candidates for urban transformation in this citywide study. To categorize urban space in terms of urban transformation, Grouping Analysis in ArcGIS 10.6.1 was conducted to data that includes each component scores in significantly clustered grids. Due to Pseudo Statistics and Box Plots, 6 groups with the highest F stats were extracted. As a result of the mapping of the groups, it can be said that 6 groups can be interpreted in a more meaningful manner in relation to the urban space. The method presented in this study can be magnified due to the availability of more spatial data. By integrating with other data to be obtained during the planning process, this method can contribute to the continuation of research and decision-making processes of urban transformation master plans on a more consistent basis.

Keywords: urban transformation, GIS, disaster risk assessment, Kocaeli

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3959 Socio-Cultural Factors Influencing Adherence to Anti-Retroviral Therapy among HIV Patients in a University Teaching Hospital in South-Western Nigeria

Authors: Okunola Oluseye Ademola

Abstract:

The study investigated various socio-cultural factors influencing adherence to antiretroviral drugs among people living with HIV in a University Teaching Hospital in South-western Nigeria. The objectives are to examine the perception of people living with HIV/AIDS (PLWHA) of antiretroviral therapy (ART) in Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, investigate the influence of socio-cultural factors on adherence of PLWHA to treatment regimen in the study area and assess the prevalence of adherence to ART among PLWHA in the study area. It was a cross-sectional where both qualitative and quantitative research methods were adopted. The participants were HIV diagnosed patients attending clinic at the Obafemi Awolowo University Teaching Hospitals Complex in Ile-Ife between the ages of 18 and 60 years. Also three healthcare delivery personnel working in the clinic were interviewed. Out of the 3007 patients receiving treatment, using Fischer’s formula of sampling technique, 336 patients living with HIV/AIDS were selected for the study. These participants had been on antiretroviral drugs for more than six months prior to the study and were selected using simple random sampling technique. Two focus group discussion sessions comprising of 10 male and 10 female living with HIV and currently on ART were conducted. These groups were purposively selected based on their being on ART for more than one year. Also in-depth interviews were conducted among three purposively selected healthcare givers (an experienced nurse, a doctor and a pharmacist) who are working in this clinic. All the participants were interviewed at the clinic on the various clinic days. Data were collected using a structured questionnaire, an interview guide and tape-recorder. The quantitative data were analysed using descriptive and inferential statistics. Content analysis was employed to analyse responses from IDI and FGD sessions. The findings from the study revealed a very positive perception to ART among PLWHA which was about 86.3% while the level of adherence to ART was 89.0% among the respondents. There was a very strong relationship between social and family supports and the degree of adherence to ART in the PLWHA. Nutrition, polygamy, difficulty in financing transportation fare to the clinic, unemployment, drug hawkers, religion, excuse duty from work and waking up very early were highlighted as socio-cultural barriers to adherence to ART. Fear of death, strong family support, religion belief, not seeking alternative treatment, absence of rituals and perceived improved health status were identified as very strong facilitators to adherence. The study concluded that to achieve a very optimal outcome in the management of HIV among PLWHA, various social and cultural contexts should be taken into consideration as this study was able to ascertain the influence of various socio-cultural factors militating and facilitating adherence to ART.

Keywords: ART, HIV, PLWHA, socio-cultural

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3958 Analyze Long-Term Shoreline Change at Yi-Lan Coast, Taiwan Using Multiple Sources

Authors: Geng-Gui Wang, Chia-Hao Chang, Jee-Cheng Wu

Abstract:

A shoreline is a line where a body of water and the shore meet. It provides economic and social security to coastal habitations. However, shorelines face multiple threats due to both natural processes and man-made effects because of disasters, rapid urbanization, industrialization, and sand deposition and erosion, etc. In this study, we analyzed multi-temporal satellite images of the Yilan coast, Taiwan from 1978 to 2016, using the United States Geological Survey (USGS) Digital Shoreline Analysis System (DSAS), weather information (as rainfall records and typhoon routes), and man-made construction project data to explore the causes of shoreline changes. The results showed that the shoreline at Yilan coast is greatly influenced by typhoons and anthropogenic interventions.

Keywords: shoreline change, multi-temporal satellite, digital shoreline analysis system, DSAS, Yi-Lan coast

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3957 Enhancing Emotional Regulation in Autistic Students with Intellectual Disabilities through Visual Dialogue: An Action Research Study

Authors: Tahmina Huq

Abstract:

This paper presents the findings of an action research study that aimed to investigate the efficacy of a visual dialogue strategy in assisting autistic students with intellectual disabilities in managing their immediate emotions and improving their academic achievements. The research sought to explore the effectiveness of teaching self-regulation techniques as an alternative to traditional approaches involving segregation. The study identified visual dialogue as a valuable tool for promoting self-regulation in this specific student population. Action research was chosen as the methodology due to its suitability for immediate implementation of the findings in the classroom. Autistic students with intellectual disabilities often face challenges in controlling their emotions, which can disrupt their learning and academic progress. Conventional methods of intervention, such as isolation and psychologist-assisted approaches, may result in missed classes and hindered academic development. This study introduces the utilization of visual dialogue between students and teachers as an effective self-regulation strategy, addressing the limitations of traditional approaches. Action research was employed as the methodology for this study, allowing for the direct application of the findings in the classroom. The study observed two 15-year-old autistic students with intellectual disabilities who exhibited difficulties in emotional regulation and displayed aggressive behaviors. The research question focused on the effectiveness of visual dialogue in managing the emotions of these students and its impact on their learning outcomes. Data collection methods included personal observations, log sheets, personal reflections, and visual documentation. The study revealed that the implementation of visual dialogue as a self-regulation strategy enabled the students to regulate their emotions within a short timeframe (10 to 30 minutes). Through visual dialogue, they were able to express their feelings and needs in socially appropriate ways. This finding underscores the significance of visual dialogue as a tool for promoting emotional regulation and facilitating active participation in classroom activities. As a result, the students' learning outcomes and social interactions were positively impacted. The findings of this study hold significant implications for educators working with autistic students with intellectual disabilities. The use of visual dialogue as a self-regulation strategy can enhance emotional regulation skills and improve overall academic progress. The action research approach outlined in this paper provides practical guidance for educators in effectively implementing self-regulation strategies within classroom settings. In conclusion, the study demonstrates that visual dialogue is an effective strategy for enhancing emotional regulation in autistic students with intellectual disabilities. By employing visual communication, students can successfully regulate their emotions and actively engage in classroom activities, leading to improved learning outcomes and social interactions. This paper underscores the importance of implementing self-regulation strategies in educational settings to cater to the unique needs of autistic students.

Keywords: action research, self-regulation, autism, visual communication

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3956 Effect of Community Education and Early Intervention and Rehabilitation in Minimising the Impact on Mental Illness

Authors: Akanle Florence Foluso, Richard Oni, Ola Tolulo, Lani Ofie

Abstract:

Health is a state of complete physical, mental, and social wellbeing and not merely the absence of disease or infirmity. Society’s attitude to mental health and primary prevention is the key instrument in a better understanding of the mental illness. This paper attempted to investigate the effect of community education and early intervention and rehabilitation in minimizing the impact of mental illness. The study involved 50 adolescents who were randomly selected and assigned to two groups, the control and the experimental. Subjects in the experimental group were exposed to treatment, while those in the control group were not. The subject exposed to treatment had an increased understanding of what mental illness is. Those with mental illness were better understood, less feared, less discriminated against, and tertiary prevention strategies were reported to minimize the impact of mental illness when it occurs

Keywords: community, health, improve, status

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3955 Biomaterials Solutions to Medical Problems: A Technical Review

Authors: Ashish Thakur

Abstract:

This technical paper was written in view of focusing the biomaterials and its various applications in modern industries. Author tires to elaborate not only the medical, infect plenty of application in other industries. The scope of the research area covers the wide range of physical, biological and chemical sciences that underpin the design of biomaterials and the clinical disciplines in which they are used. A biomaterial is now defined as a substance that has been engineered to take a form which, alone or as part of a complex system, is used to direct, by control of interactions with components of living systems, the course of any therapeutic or diagnostic procedure. Biomaterials are invariably in contact with living tissues. Thus, interactions between the surface of a synthetic material and biological environment must be well understood. This paper reviews the benefits and challenges associated with surface modification of the metals in biomedical applications. The paper also elaborates how the surface characteristics of metallic biomaterials, such as surface chemistry, topography, surface charge, and wettability, influence the protein adsorption and subsequent cell behavior in terms of adhesion, proliferation, and differentiation at the biomaterial–tissue interface. The chapter also highlights various techniques required for surface modification and coating of metallic biomaterials, including physicochemical and biochemical surface treatments and calcium phosphate and oxide coatings. In this review, the attention is focused on the biomaterial-associated infections, from which the need for anti-infective biomaterials originates. Biomaterial-associated infections differ markedly for epidemiology, aetiology and severity, depending mainly on the anatomic site, on the time of biomaterial application, and on the depth of the tissues harbouring the prosthesis. Here, the diversity and complexity of the different scenarios where medical devices are currently utilised are explored, providing an overview of the emblematic applicative fields and of the requirements for anti-infective biomaterials. In addition to this, chapter introduces nanomedicine and the use of both natural and synthetic polymeric biomaterials, focuses on specific current polymeric nanomedicine applications and research, and concludes with the challenges of nanomedicine research. Infection is currently regarded as the most severe and devastating complication associated to the use of biomaterials. Osteoporosis is a worldwide disease with a very high prevalence in humans older than 50. The main clinical consequences are bone fractures, which often lead to patient disability or even death. A number of commercial biomaterials are currently used to treat osteoporotic bone fractures, but most of these have not been specifically designed for that purpose. Many drug- or cell-loaded biomaterials have been proposed in research laboratories, but very few have received approval for commercial use. Polymeric nanomaterial-based therapeutics plays a key role in the field of medicine in treatment areas such as drug delivery, tissue engineering, cancer, diabetes, and neurodegenerative diseases. Advantages in the use of polymers over other materials for nanomedicine include increased functionality, design flexibility, improved processability, and, in some cases, biocompatibility.

Keywords: nanomedicine, tissue, infections, biomaterials

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3954 Analysis and Forecasting of Bitcoin Price Using Exogenous Data

Authors: J-C. Leneveu, A. Chereau, L. Mansart, T. Mesbah, M. Wyka

Abstract:

Extracting and interpreting information from Big Data represent a stake for years to come in several sectors such as finance. Currently, numerous methods are used (such as Technical Analysis) to try to understand and to anticipate market behavior, with mixed results because it still seems impossible to exactly predict a financial trend. The increase of available data on Internet and their diversity represent a great opportunity for the financial world. Indeed, it is possible, along with these standard financial data, to focus on exogenous data to take into account more macroeconomic factors. Coupling the interpretation of these data with standard methods could allow obtaining more precise trend predictions. In this paper, in order to observe the influence of exogenous data price independent of other usual effects occurring in classical markets, behaviors of Bitcoin users are introduced in a model reconstituting Bitcoin value, which is elaborated and tested for prediction purposes.

Keywords: big data, bitcoin, data mining, social network, financial trends, exogenous data, global economy, behavioral finance

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3953 Associated Problems with the Open Dump Site and Its Possible Solutions

Authors: Pangkaj Kumar Mahanta, Md. Rafizul Islam

Abstract:

The rapid growth of the population causes a substantial amount of increase in household waste all over the world. Waste management is becoming one of the most challenging phenomena in the present day. The most environmentally friendly final disposal process of waste is sanitary landfilling, which is practiced in most developing countries. However, in Southeast Asia, most of the final disposal point is an open dump site. Due to the ignominy of proper management of waste and monitoring, the surrounding environment gets polluted more by the open dump site in comparison with a sanitary landfill. Khulna is 3rd largest metropolitan city in Bangladesh, having a population of around 1.5 million and producing approximately 450 tons per day of Municipal Solid Waste. The Municipal solid waste of Khulna city is disposed of in Rajbandh open dump site. The surrounding air is being polluted by the gas produced in the open dump site. Also, the open dump site produces leachate, which contains various heavy metals like Cadmium (Cd), Chromium (Cr), Lead (Pb), Manganese (Mn), Mercury (Hg), Strontium (Sr), etc. Leachate pollutes the soil as well as the groundwater of the open dump site and also the surrounding area through seepage. Moreover, during the rainy season, the surface water is polluted by leachate runoff. Also, the plastic waste flowing out from the open dump site through various drivers pollutes the nearby environment. The health risk assessment associated with heavy metals was carried out by computing the chronic daily intake (CDI), hazard quotient (HQ), and hazard index (HI) via different exposure pathways following the USEPA guidelines. For ecological risk, potential contamination index (Cp), Contamination factor (CF), contamination load index (PLI), numerical integrated contamination factor (NICF), enrichment factor (EF), ecological risk index (ER), and potential ecological risk index (PERI) were computed. The health risk and ecological risk assessment results reveal that some heavy metals possess strong health and ecological risk. In addition, the child faces higher harmful health risks from several heavy metals than the adult for all the exposure pathways and media. The conversion of an open dump site into a sanitary landfill and a proper management system can reduce the problems associated with an open dump site. In the sanitary landfill, the produced gas will be managed properly to save the surrounding atmosphere from being polluted. The seepage of leachate can be minimized by installing a compacted clay layer (CCL) as a baseline and leachate collection in a sanitary landfill to save the underlying soil layer and surrounding water bodies from leachate. Another important component of a sanitary landfill is the conversion of plastic waste to energy will minimize the plastic pollution in the landfill area and also the surrounding soil and water bodies. Also, in the sanitary landfill, the bio-waste can be used to make compost to reduce the volume of bio-waste and proper utilization of the landfill area.

Keywords: ecological risk, health risk, open dump site, sanitary landfill

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3952 Using Business Interactive Games to Improve Management Skills

Authors: Nuno Biga

Abstract:

Continuous processes’ improvement is a permanent challenge for managers of any organization. Lean management means that efficiency gains can be obtained through a systematic framework able to explore synergies between processes, eliminate waste of time, and other resources. Leaderships in organizations determine the efficiency of the teams through their influence on collaborators, their motivation, and consolidation of ownership (group) feeling. The “organization health” depends on the leadership style, which is directly influenced by the intrinsic characteristics of each personality and leadership ability (leadership competencies). Therefore, it’s important that managers can correct in advance any deviation from expected leadership exercises. Top management teams must assume themselves as regulatory agents of leadership within the organization, ensuring monitoring of actions and the alignment of managers in accordance with the humanist standards anchored in a visible Code of Ethics and Conduct. This article is built around an innovative model of “Business Interactive Games” (BI GAMES) that simulates a real-life management environment. It shows that the strategic management of operations depends on a complex set of endogenous and exogenous variables to the intervening agents that require specific skills and a set of critical processes to monitor. BI GAMES are designed for each management reality and have already been applied successfully in several contexts over the last five years comprising the educational and enterprise ones. Results from these experiences are used to demonstrate how serious games in working living labs contributed to improve the organizational environment by focusing on the evaluation of players’ (agents’) skills, empower its capabilities, and the critical factors that create value in each context. The implementation of the BI GAMES simulator highlights that leadership skills are decisive for the performance of teams, regardless of the sector of activity and the specificities of each organization whose operation is intended to simulate. The players in the BI GAMES can be managers or employees of different roles in the organization or students in the learning context. They interact with each other and are asked to decide/make choices in the presence of several options for the follow-up operation, for example, when the costs and benefits are not fully known but depend on the actions of external parties (e.g., subcontracted enterprises and actions of regulatory bodies). Each team must evaluate resources used/needed in each operation, identify bottlenecks in the system of operations, assess the performance of the system through a set of key performance indicators, and set a coherent strategy to improve efficiency. Through the gamification and the serious games approach, organizational managers will be able to confront the scientific approach in strategic decision-making versus their real-life approach based on experiences undertaken. Considering that each BI GAME’s team has a leader (chosen by draw), the performance of this player has a direct impact on the results obtained. Leadership skills are thus put to the test during the simulation of the functioning of each organization, allowing conclusions to be drawn at the end of the simulation, including its discussion amongst participants.

Keywords: business interactive games, gamification, management empowerment skills, simulation living labs

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3951 The Burmese Exodus of 1942: Towards Evolving Policy Protocols for a Refugee Archive

Authors: Vinod Balakrishnan, Chrisalice Ela Joseph

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The Burmese Exodus of 1942, which left more than 4 lakh as refugees and thousands dead, is one of the worst forced migrations in recorded history. Adding to the woes of the refugees is the lack of credible documentation of their lived experiences, trauma, and stories and their erasure from recorded history. Media reports, national records, and mainstream narratives that have registered the exodus provide sanitized versions which have reduced the refugees to a nameless, faceless mass of travelers and obliterated their lived experiences, trauma, and sufferings. This attitudinal problem compels the need to stem the insensitivity that accompanies institutional memory by making a case for a more humanistically evolved policy that puts in place protocols for the way the humanities would voice the concern for the refugee. A definite step in this direction and a far more relevant project in our times is the need to build a comprehensive refugee archive that can be a repository of the refugee experiences and perspectives. The paper draws on Hannah Arendt’s position on the Jewish refugee crisis, Agamben’s work on statelessness and citizenship, Foucault’s notion of governmentality and biopolitics, Edward Said’s concepts on Exile, Fanon’s work on the dispossessed, Derrida’s work on ‘the foreigner and hospitality’ in order to conceptualize the refugee condition which will form the theoretical framework for the paper. It also refers to the existing scholarship in the field of refugee studies such as Roger Zetter’s work on the ‘refugee label’, Philip Marfleet’s work on ‘refugees and history’, Lisa Malkki’s research on the anthropological discourse of the refugee and refugee studies. The paper is also informed by the work that has been done by the international organizations to address the refugee crisis. The emphasis is on building a strong argument for the establishment of the refugee archive that finds but a passing and a none too convincing reference in refugee studies in order to enable a multi-dimensional understanding of the refugee crisis. Some of the old questions cannot be dismissed as outdated as the continuing travails of the refugees in different parts of the world only remind us that they are still, largely, unanswered. The questions are -What is the nature of a Refugee Archive? How is it different from the existing historical and political archives? What are the implications of the refugee archive? What is its contribution to refugee studies? The paper draws on Diana Taylor’s concept of the archive and the repertoire to theorize the refugee archive as a repository that has the documentary function of the ‘archive’ and the ‘agency’ function of the repertoire. It then reads Ayya’s Accounts- a memoir by Anand Pandian -in the light of Hannah Arendt’s concepts of the ‘refugee as vanguard’ and ‘story telling as political action’- to illustrate how the memoir contributes to the refugee archive that provides the refugee a place and agency in history. The paper argues for a refugee archive that has implications for the formulation of inclusive refugee policies.

Keywords: Ayya’s Accounts, Burmese Exodus, policy protocol, refugee archive

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3950 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education

Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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3949 Chronically Ill Patient Satisfaction: An Indicator of Quality of Service Provided at Primary Health Care Settings in Alexandria

Authors: Alyaa Farouk Ibrahim, Gehan ElSayed, Ola Mamdouh, Nazek AbdelGhany

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Background: Primary health care (PHC) can be considered the first contact between the patient and the health care system. It includes all the basic health care services to be provided to the community. Patient's satisfaction regarding health care has often improved the provision of care, also considered as one of the most important measures for evaluating the health care. Objective: This study aims to identify patient’s satisfaction with services provided at the primary health care settings in Alexandria. Setting: Seven primary health care settings representing the seven zones of Alexandria governorate were selected randomly and included in the study. Subjects: The study comprised 386 patients attended the previously selected settings at least twice before the time of the study. Tools: Two tools were utilized for data collection; sociodemographic characteristics and health status structured interview schedule and patient satisfaction scale. Reliability test for the scale was done using Cronbach's Alpha test, the result of the test ranged between 0.717 and 0.967. The overall satisfaction was computed and divided into high, medium, and low satisfaction. Results: Age of the studied sample ranged between 19 and 62 years, more than half (54.2%) of them aged 40 to less than 60 years. More than half (52.8%) of the patients included in the study were diabetics, 39.1% of them were hypertensive, 19.2% had cardiovascular diseases, the rest of the sample had tumor, liver diseases, and orthopedic/neurological disorders (6.5%, 5.2% & 3.2%, respectively). The vast majority of the study group mentioned high satisfaction with overall service cost, environmental conditions, medical staff attitude and health education given at the PHC settings (87.8%, 90.7%, 86.3% & 90.9%, respectively), however, medium satisfaction was mostly reported concerning medical checkup procedures, follow-up data and referral system (41.2%, 28.5% & 28.9%, respectively). Score level of patient satisfaction with health services provided at the assessed Primary health care settings proved to be significantly associated with patients’ social status (P=0.003, X²=14.2), occupation (P=0.011, X²=11.2), and monthly income (P=0.039, X²=6.50). In addition, a significant association was observed between score level of satisfaction and type of illness (P=0.007, X²=9.366), type of medication (P=0.014, X²=9.033), prior knowledge about the health center (P=0.050, X²=3.346), and highly significant with the administrative zone (P=0.001, X²=55.294). Conclusion: The current study revealed that overall service cost, environmental conditions, staff attitude and health education at the assessed primary health care settings gained high patient satisfaction level, while, medical checkup procedures, follow-up, and referral system caused a medium level of satisfaction among assessed patients. Nevertheless, social status, occupation, monthly income, type of illness, type of medication and administrative zones are all factors influencing patient satisfaction with services provided at the health facilities.

Keywords: patient satisfaction, chronic illness, quality of health service, quality of service indicators

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